Inability to access health care due to COVID-19 among Medicare beneficiaries.

ABSTRACT

OBJECTIVES: The understanding of which factors are associated with inability to access health care services due to the COVID-19 pandemic is limited. We aimed to examine factors associated with being unable to access health care due to the pandemic among Medicare beneficiaries. STUDY DESIGN: A cross-sectional study. METHODS: We analyzed the summer and fall 2020 Medicare Current Beneficiary Survey COVID-19 Rapid Response Supplement Questionnaire data. Our study included community-dwelling Medicare beneficiaries 65 years and older (summer n = 8751; fall n = 7421). Logistic regressions were used to examine factors (eg, sociodemographics, comorbidities) associated with being unable to access health care services due to the pandemic. RESULTS: Approximately 20.9% and 7.5% of the beneficiaries reported they were unable to access health care services due to the pandemic in the summer and fall of 2020, respectively. The most frequent types of services that beneficiaries were unable to access were dental care (summer, 45.5%; fall, 35.1%) and regular check-ups (summer, 35.9%; fall, 46.1%). Beneficiaries who reported a higher income (income ≥ $25,000) (summer odds ratio [OR], 1.55; P < .001; fall OR, 1.52; P = .002) or speaking English at home (summer OR, 1.50; P = .016; fall OR, 1.53; P = .082) were more likely to report being unable to access services than their counterparts (lower income or speaking a language other than English at home). Beneficiaries with at least 4 chronic conditions were unable to access health care significantly more often than those with 1 or no conditions. CONCLUSIONS: Given that sociodemographics and comorbidity burden contributed to the disparities that we observed in accessibility of health care services due to the pandemic, these findings can allow decision makers to target resource allocation and outreach efforts to those populations most at risk.